Esther Neelis1, Stefanie Kouwenhoven2, Joanne Olieman3,4, Merit Tabbers5, Cora Jonkers6, Jonathan Wells7, Mary Fewtrell7, René Wijnen3, Edmond Rings1,8, Barbara de Koning1, Jessie Hulst1. 1. Department of Pediatric Gastroenterology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands. 2. Department of Pediatrics, Amsterdam UMC, Vrije Universiteit Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands. 3. Department of Pediatric Surgery, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands. 4. Department of Dietetics, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands. 5. Department of Pediatric Gastroenterology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands. 6. Department of Dietetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 7. UCL Great Ormond Street Institute of Child Health, London, United Kingdom. 8. Department of Pediatric Gastroenterology, Leiden University Medical Center - Willem Alexander Children's Hospital, Leiden, the Netherlands.
Abstract
BACKGROUND: Children with intestinal failure (IF) are at risk of growth failure, but little information about body composition is available. Our aim was to assess body composition using air displacement plethysmography (ADP) and relate it to clinical and growth parameters. METHODS: In this prospective descriptive observational 2-center cohort study, children aged 2-18 years receiving home parenteral nutrition (PN) for ≥6 months underwent ADP measurement. Fat mass index (FMI) and fat-free mass index (FFMI) standard deviation scores (SDSs) were calculated to normalize for small body size. RESULTS: Twenty-one out of 22 children, median age 7.4 years, underwent successful ADP measurement after a median PN duration of 5.5 years. They were significantly lighter (median weight for age SDS -0.71, P = 0.004) and shorter (median height for age SDS -1.55, P < 0.001) than the normal population mean; 52% were growing below target height range. They had low FFMI (median SDS -1.53, P < 0.001) and high FMI (median SDS 0.80, P = 0.002). Weight for height and body mass index (BMI) were significantly associated with FFMI and BMI with FMI, but children with the same weight and height showed different body composition. In 13 patients with 1-year follow-up, growth and body composition did not change significantly. CONCLUSION: Children with IF receiving long-term PN show lower FFM and higher FM than healthy children. Additionally, children with similar routine growth parameters showed different body composition. Further studies should evaluate the effect of a patient-tailored approach including physical activity and nutrition advice based on body composition.
BACKGROUND:Children with intestinal failure (IF) are at risk of growth failure, but little information about body composition is available. Our aim was to assess body composition using air displacement plethysmography (ADP) and relate it to clinical and growth parameters. METHODS: In this prospective descriptive observational 2-center cohort study, children aged 2-18 years receiving home parenteral nutrition (PN) for ≥6 months underwent ADP measurement. Fat mass index (FMI) and fat-free mass index (FFMI) standard deviation scores (SDSs) were calculated to normalize for small body size. RESULTS: Twenty-one out of 22 children, median age 7.4 years, underwent successful ADP measurement after a median PN duration of 5.5 years. They were significantly lighter (median weight for age SDS -0.71, P = 0.004) and shorter (median height for age SDS -1.55, P < 0.001) than the normal population mean; 52% were growing below target height range. They had low FFMI (median SDS -1.53, P < 0.001) and high FMI (median SDS 0.80, P = 0.002). Weight for height and body mass index (BMI) were significantly associated with FFMI and BMI with FMI, but children with the same weight and height showed different body composition. In 13 patients with 1-year follow-up, growth and body composition did not change significantly. CONCLUSION:Children with IF receiving long-term PN show lower FFM and higher FM than healthy children. Additionally, children with similar routine growth parameters showed different body composition. Further studies should evaluate the effect of a patient-tailored approach including physical activity and nutrition advice based on body composition.
Authors: Lotte E Vlug; Esther G Neelis; Jonathan C K Wells; Mary S Fewtrell; Wendy L M Kastelijn; Joanne F Olieman; Marijn J Vermeulen; Jorine A Roelants; Dimitris Rizopoulos; René M H Wijnen; Edmond H H M Rings; Barbara A E de Koning; Jessie M Hulst Journal: Am J Clin Nutr Date: 2022-02-09 Impact factor: 7.045
Authors: Lotte E Vlug; Patric J D Delhanty; Esther G Neelis; Martin Huisman; Jenny A Visser; Edmond H H M Rings; René M H Wijnen; Sjoerd C J Nagelkerke; Merit M Tabbers; Jessie M Hulst; Barbara A E de Koning Journal: Front Nutr Date: 2022-05-11
Authors: Lotte E Vlug; Sjoerd C J Nagelkerke; Cora F Jonkers-Schuitema; Edmond H H M Rings; Merit M Tabbers Journal: Nutrients Date: 2020-01-08 Impact factor: 5.717
Authors: Victoria A A Beunders; Jorine A Roelants; Jessie M Hulst; Dimitris Rizopoulos; Anita C S Hokken-Koelega; Esther G Neelis; Kirsten S de Fluiter; Vincent W V Jaddoe; Irwin K M Reiss; Koen F M Joosten; Marijn J Vermeulen Journal: Pediatr Obes Date: 2020-11-17 Impact factor: 4.000